Correlates of unprotected sex by client type among female sex workers that inject drugs in Tijuana and Ciudad Juarez, Mexico

  • Ryan P. Lindsay Idaho State University
  • Scott C. Roesch San Diego State University
  • Steffanie A. Strathdee University of California San Diego
  • M. Gudelia Rangel Secretaría de Salud y Comisión de Salud Fronteriza México-Estados Unidos
  • Hugo S. Staines-Orozco Universidad Autónoma de Ciudad Juarez
  • Daniela Abramovitz University of California San Diego
  • Monica D. Ulibarri University of California San Diego
  • Melanie L.A. Rusch Vancouver Island Health Authority
Keywords: HIV/AIDS, unprotected sex, female sex workers, injection drug use, risk environment

Abstract

Lindsay, R., Roesch, S., Strathdee, S., Rangel, M., Staines-Orozco, H., Abramovitz, D., Ulibarri, M., & Rusch, M. (2015). Correlates of unprotected sex by client type among female sex workers that inject drugs in Tijuana and Ciudad Juarez, Mexico. The International Journal Of Alcohol And Drug Research, 4(2), 159-169. doi:http://dx.doi.org/10.7895/ijadr.v4i2.208

Aims: Risk environment factors may influence unprotected sex between female sex workers who are also injection drug users
(FSW-IDUs) and their regular and non-regular clients differently. Our objective is to identify correlates of unprotected vaginal
sex in the context of client type.

Methods: A cross-sectional survey of 583 FSW-IDUs in Tijuana and Ciudad Juarez, Mexico, was analyzed using negative
binomial regression to determine physical, social, economic, and policy risk-environment factors that affect the frequency of
unprotected sex with regular and non-regular clients.

Results: Median number of unprotected vaginal sex acts in the past month among FSW-IDUs and their regular and non-regular
clients was 11 (IQR 3–30) and 13 (IQR 5–30), respectively. Correlates differed by site and client type and were most closely
associated with the risk environment. In Tijuana, social factors (e.g., injecting drugs with clients) were independently associated
with more unprotected sex. Factors independently associated with less unprotected sex across client type and site included social
and economic risk environment factors (e.g., receiving more money for unprotected sex). In the policy risk environment, always
having free access to condoms was independently associated with less unprotected sex among non-regular clients in Tijuana
(Risk rate ratio = 0.64; 95% confidence interval 0.43–0.97).

Conclusions: Primarily physical, social, and economic risk-environment factors were associated with unprotected vaginal sex
between FSW-IDUs and both client types, suggesting potential avenues for intervention.

Author Biographies

Ryan P. Lindsay, Idaho State University
Department of Community and Public Health, Idaho State University-Meridian Campus, Meridian, ID, United States
Scott C. Roesch, San Diego State University
Department of Psychology, San Diego State University, San Diego, CA, United States
Steffanie A. Strathdee, University of California San Diego
Department of Medicine, University of California San Diego, La Jolla, CA, United States
M. Gudelia Rangel, Secretaría de Salud y Comisión de Salud Fronteriza México-Estados Unidos
Secretaría de Salud y Comisión de Salud Fronteriza México-Estados Unidos, Tijuana, BC, Mexico
Hugo S. Staines-Orozco, Universidad Autónoma de Ciudad Juarez
Instituto de Ciencias Biomédicas, Universidad Autónoma de Ciudad Juarez, Juárez, Chih., Mexico
Daniela Abramovitz, University of California San Diego
Department of Medicine, University of California San Diego, La Jolla, CA, United States
Monica D. Ulibarri, University of California San Diego
Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
Melanie L.A. Rusch, Vancouver Island Health Authority
Vancouver Island Health Authority, Victoria, British Columbia, Canada
Published
2015-12-18
How to Cite
Lindsay, R. P., Roesch, S. C., Strathdee, S. A., Rangel, M. G., Staines-Orozco, H. S., Abramovitz, D., Ulibarri, M. D., & Rusch, M. L. (2015). Correlates of unprotected sex by client type among female sex workers that inject drugs in Tijuana and Ciudad Juarez, Mexico. International Journal of Alcohol and Drug Research, 4(2), 159-169. https://doi.org/10.7895/ijadr.v4i2.208
Section
Other Papers